File PROSTHETICS_1358(664) Data List
| DATE |
OBLIGATION NUMBER |
PATIENT |
INITIATOR |
EST. SHIPPING CHARGE |
ACT. SHIPPING CHARGE |
SHIPPING ENTRY |
PICKUP/DELIVERY REMARKS |
FORM TYPE |
PSC CATEGORY |
PERCENT DISCOUNT |
STATION NAME |
DELIVER TO |
BILLING ITEM |
DATE REQUIRED |
DELIVERY TIME |
DELIVER TO ATTENTION |
WORK ORDER NUMBER |
LAB TECHNICIAN |
2529-3 |
PURCHASE CARD NUMBER |
BANK AUTHORIZATION NUMBER |
EST AMOUNT |
CLOSE-OUT AMOUNT |
NEW PURCHASE CARD NUMBER |
CANCELLATION DATE |
CANCELLATION REMARKS |
CANCELLED BY |
AUDIT REPAIR |
AUDIT DATE |
VENDOR |
C.P. |
REFERENCE |
IFCAP ORDER |
PURCHASE CARD REFERENCE |
CLOSE OUT DATE |
CLOSE-OUT REMARKS |
CLOSED BY |
LAST IFCAP AMEND BY |
LAST AMEND TOTAL |
LAST AMEND REPRINT OK |